Hillenbrand Karin M, Larsen Pamela G
Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina 27858, USA.
Pediatrics. 2002 Nov;110(5):e59. doi: 10.1542/peds.110.5.e59.
Breastfeeding is the preferred nutrition for infants, but many pediatricians report inadequate training to advise mothers who breastfeed. This study was designed to examine the effect of an educational intervention on pediatric residents' knowledge about breastfeeding, their confidence in addressing lactation issues, and their management skills during clinical encounters with breastfeeding mothers.
An interactive multimedia curricular intervention was designed for pediatric residents to increase their knowledge about common lactation issues. The residents completed questionnaires before and after the intervention to measure knowledge and confidence. Resident behaviors in the clinical setting were measured before and after the intervention using telephone surveys of breastfeeding mothers after a clinic visit with a pediatric resident.
Forty-nine pediatric residents participated in the study. Mean knowledge scores increased from 69% before the intervention to 80% after the intervention. Significant increases in knowledge included advising mothers about low milk supply, mastitis, abscess, or using medication, and in recognizing the benefit of the decreased risk of maternal cancer. Management skills with breastfeeding mothers and infants in the clinical setting improved significantly. Before the intervention residents performed an acceptable number of behaviors 22% of the time, while after the intervention their performance was acceptable 65% of the time. Particular behaviors that showed significant improvement after the intervention included discussing signs of breastfeeding adequacy with the mother and correct management of lactation problems.
These results indicate that not only breastfeeding knowledge and confidence, but most importantly clinical behaviors of pediatric residents can be enhanced through innovative educational opportunities. Appropriate counseling for breastfeeding mothers by pediatricians might contribute to an increase in the duration of breastfeeding.
母乳喂养是婴儿的首选营养方式,但许多儿科医生表示,他们在为母乳喂养的母亲提供建议方面缺乏足够的培训。本研究旨在探讨一项教育干预措施对儿科住院医师母乳喂养知识、处理哺乳问题的信心以及在与母乳喂养母亲临床接触时的管理技能的影响。
为儿科住院医师设计了一种交互式多媒体课程干预措施,以增加他们对常见哺乳问题的了解。住院医师在干预前后完成问卷,以测量知识和信心。通过对儿科住院医师门诊后母乳喂养母亲的电话调查,测量干预前后住院医师在临床环境中的行为。
49名儿科住院医师参与了该研究。平均知识得分从干预前的69%提高到干预后的80%。知识的显著增加包括就乳汁供应不足、乳腺炎、脓肿或用药向母亲提供建议,以及认识到降低母亲患癌风险的益处。在临床环境中与母乳喂养母亲和婴儿的管理技能有显著提高。干预前,住院医师22%的时间表现出可接受的行为数量,而干预后,他们65%的时间表现可接受。干预后表现出显著改善的具体行为包括与母亲讨论母乳喂养充足的迹象以及正确处理哺乳问题。
这些结果表明,通过创新的教育机会,不仅可以提高母乳喂养知识和信心,更重要的是可以增强儿科住院医师的临床行为。儿科医生对母乳喂养母亲进行适当的咨询可能有助于延长母乳喂养时间。